Atherosclerosis is associated with erectile function and lower urinary tract symptoms, especially nocturia, in middle-aged men

Abstract

BackgroundAtherosclerosis is a systematic disease in which plaque builds up inside the arteries that can lead to serious problems related to quality of life (QOL). Lower urinary tract symptoms (LUTS), erectile dysfunction (ED), and late-onset hypogonadism (LOH) are highly prevalent in aging men and are significantly associated with a reduced QOL. However, few questionnaire-based studies have fully examined the relation between atherosclerosis and several urological symptoms.Materials and methodsThe study comprised 303 outpatients who visited our clinic with symptoms of LOH. Several factors influencing atherosclerosis, including serum concentrations of triglyceride, fasting blood sugar, and total testosterone measured by radioimmunoassay, were investigated. We also measured brachial-ankle pulse wave velocity (baPWV) and assessed symptoms by specific questionnaires, including the Sexual Health Inventory for Men (SHIM), Erection Hardness Score (EHS), International Prostate Symptom Score (IPSS), QOL index, and Aging Male Symptoms rating scale (AMS). Stepwise associations between the ratio of measured/age standard baPWV and clinical factors including laboratory data and the scores of the questionnaires were compared using the Jonckheere–Terpstra test for trend. The associations between the ratio of measured/age standard baPWV and each IPSS score were assessed in a multivariate linear regression model after adjustment for serum triglyceride, fasting blood sugar, and total testosterone.ResultsRegarding ED, a higher level of the ratio of measured/age standard baPWV was associated with a lower EHS, whereas no association was found with SHIM. Regarding LUTS, a higher ratio of measured/age standard baPWV was associated with a higher IPSS and QOL index. However, there was no statistically significant difference between the ratio of measured/age standard baPWV and AMS. A multivariate linear regression model showed only nocturia to be associated with the ratio of measured/age standard baPWV for each IPSS score.ConclusionAtherosclerosis is associated with erectile function and LUTS, especially nocturia.

Serum C‐reactive protein level is not associated with prostatic inflammation but with overactive detrusor in patients with benign prostatic hyperplasia

“…In the present study, the serum CRP level was particularly associated with the severity of nocturia. Some reports have demonstrated an association between atherosclerosis and nocturia . Considering the relationship between CRP and atherosclerosis, the association between nocturia and the serum CRP level in our present investigation might be explained by atherosclerosis.…”

Future Considerations in Nocturia and Nocturnal Polyuria

“…These findings are supported by another study of 303 Japanese men with late-onset hypogonadism, in which nocturia was found to be associated with a higher brachial-ankle PWV on a multivariate linear regression model after adjustment for serum triglycerides, fasting blood sugar, and total testosterone. 37 As PWV is an indicator of arterial stiffness, 33 these results also support a relationship between nocturia and arteriopathy. 37…”

Atherosclerosis as a predictor of transient exacerbation of overactive bladder symptoms after robot‐assisted laparoscopic radical prostatectomy

“…In contrast, in the present study, there was no significant difference in the volume of urinary incontinence evaluated by the 1‐h pad test between the atherosclerosis group and the control group (data not shown). Although the 1‐h pad test included the provocation maneuver “washing hands by running water,” which could induce urgency incontinence, the reason why a significant difference between the two groups was not observed was that stress urinary incontinence occurs mainly due to weakened function of the external urethral sphincter after RARP . Therefore, UUI might be masked by a copious amount of stress urinary incontinence during a 1‐h pad test.…”